Glenn Acord Deyo, MD is a medicare enrolled "Surgery" physician in University Place, Washington. His current practice location is
4521 82nd Avenue Ct W, University Place, Washington. You can reach out to his office (for appointments etc.) via phone at
(253) 312-8336.
Glenn Acord Deyo is licensed to practice in Washington (license number MD00026258) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053421800.
Physician's Profile
Full Name | Glenn Acord Deyo |
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Gender | Male |
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Speciality | Surgery |
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Location | 4521 82nd Avenue Ct W, University Place, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1053421800
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 08/05/2011
Medicare PECOS Information:
- PECOS PAC ID: 9234187006
- Enrollment ID: I20120509000272
Medical Identifiers
Medical identifiers for Glenn Acord Deyo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053421800 | NPI | - | NPPES |
7030539 | Medicaid | WA | |
1054279 | Medicaid | WA | |
DE2889 | Other | WA | REGENCE BLUE SHIELD |
0054140 | Other | WA | L & I |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | MD00026258 (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Glenn Acord Deyo allows following entities to bill medicare on his behalf.
Entity Name | Penobscot Valley Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093716086 PECOS PAC ID: 8426942889 Enrollment ID: O20040209000635 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glenn Acord Deyo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Glenn Acord Deyo, MD 4521 82nd Avenue Ct W, University Place, WA 98466-2325 Ph: (253) 312-8336 | Glenn Acord Deyo, MD 4521 82nd Avenue Ct W, University Place, WA 98466-2325 Ph: (253) 312-8336 |
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